| National Provider Identifier [NPI]: | 1063699106 |
| Last Name Of The Provider | REAVEN |
| First Name Of The Provider | RICHARD |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 22 S GREENE ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | BALTIMORE |
| Zip Code Of The Provider | 212011544 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 160 |
| Number Of Services | 12064 |
| Number Of Medicare Beneficiaries | 4433 |
| Total Submitted Charge Amount | 1540511.41 |
| Total Medicare Allowed Amount | 618638.53 |
| Total Medicare Payment Amount | 525176.71 |
| Total Medicare Standardized Payment Amount | 491393.35 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 4677 |
| Number Of Medicare Beneficiaries With Drug Services | 112 |
| Total Drug Submitted ChargeAmount | 4384.34 |
| Total Drug Medicare AllowedAmount | 3067.45 |
| Total Drug Medicare PaymentAmount | 2364.31 |
| Total Drug Medicare Standardized Payment Amount | 2364.31 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 157 |
| Number Of Medical Services | 7387 |
| Number Of Medicare Beneficiaries With Medical Services | 4432 |
| Total Medical Submitted Charge Amount | 1536127.07 |
| Total Medical Medicare Allowed Amount | 615571.08 |
| Total Medical Medicare Payment Amount | 522812.4 |
| Total Medical Medicare Standardized Payment Amount | 489029.04 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 495 |
| Number Of Beneficiaries Age 65 to 74 | 2073 |
| Number Of Beneficiaries Age 75 to 84 | 1303 |
| Number Of Beneficiaries Age Greater 84 | 562 |
| Number Of Female Beneficiaries | 3528 |
| Number Of Male Beneficiaries | 905 |
| Number Of Non Hispanic White Beneficiaries | 3573 |
| Number Of Black or African American Beneficiaries | 696 |
| Number Of AsianPacific Islander Beneficiaries | 68 |
| Number Of Hispanic Beneficiaries | 53 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 3850 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 583 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.2605 |